Final Medications Flashcards
SSRI medications
Paxil (paroxetine)
Prozac (fluoxetine)
Lexapro (esclatlopram)
SSRI side effects
Initially= insomnia and anxiety Nausea Diarrhea Sleepiness Emotional flattening Decreased libido, difficulty reaching orgasm
SSRI indications
Anti- anxiety
Eating disorder
SSRI mechanism of action
Increases serotonin, indirectly acts on GABA
Used 1st in chronic anxiety disorders
3-4 weeks for sx control
Best with psychotherapy
Benzodiapene medications
Chloridiazepoxide (librium)
Lorazepam (ativan)
Benzodiapenes side effects
Drowsiness Confusion Lethargy Tolerance Psychological/ physical dependence Potentiates effects of CNS depressants (ie, alcohol) May aggravate sx of depression Orthostatic hypotension Paradoxical excitement
Benzodiapenes indications
Anti- anxiety
Tx of alcohol withdrawal (substitution therapy using Ativan)
Precautions when using benzodiapenes
Taper gradually- withdrawal from benzos can be life threatening
Contraindications in patients that have hx of substance abuse
Use cautiously in elderly (orthostatic hypotension)
Medication to treat opioid overdose
Naloxone (Narcan)
Medication to treat opioid withdrawal
Methadone (dolophine) substitution - methadone is an opioid like drug
Buprenorphine
Indications of bupropion (zyban )
Nicotine treatment
bipolar disorder is characterized by ___ ___ from euphoria to ___ with intervening periods of ____. ___ or a ___ pattern may be present
mood swings depression normalcy delusions seasonal
bipolar disorders
bipolar 1 bipolar 2 cycothymic disorder substance/ medication induced bipolar d/t another medical condition
dopamine and __ levels are excessive in ___
norepinephrine
mania
in bipolar __ dopamine and ___ levels are ___
depression
norepinphrine
deficient
medications that induce bipolar
steriods
amphetamines
antidepressents
narcotics
a ___ episode happens for at least __ week consisting of elevated, __ or ___ mood. there is marked impairment usually requiring hospitalization that is __ attributal to substances or medical condition
manic 1 expansive irritable not
sx of mania
inflated self- esteem/ grandiousity decreased need for sleep pressured speech flight of ideas distractability increased goal directed activity excess participation in activites with potentially painful results aggitation irritability aggression
hypomanic episode
4 day period of elevated expansive or irritable mood there is a change in behavior observable changes in mood no marked impairment not attributable to substance/ condition
cycothymic disorder involves ___ fluctuating mood disturbance of at least 2 years. ___ periods of elevated mood and __ mood that does not meed the criteria for ___ episode or ___. the patient is never without sx for more than __ months
chronic numerous depression hypomanic MDD 2
substance/ medication induced bipolar
direct result of substance ingestion or withdrawl causing signifcant distress and impairment
bipolar d/t another medical conditoin
direct result from another medical conditon
bipolar in children looks like ___
ADHD
restraint guidelines
less restrictive proven ineffective
behavior is a serious immediate danger to patient/ staff/ others
face to face evaluation at least every hour
15 minute checks for 1:1
debriefing
nurse can initiate but must be backed by dr within 1 hour
pharm for bipolar
mood stabalizers
- lithium
anticonvolsant
- tegretol
- depakene
- lamictil
antipsychotics
- zyprexa
- seroquel
- risperdal
ranges for bipolar
- 0- 1.5 for acute mania
maintance: 0.6- 1.2
side effects of lithium
drowsiness, dizziness, headache dry mouth, thirst n/v hand tremors polyuria, dehydration wt gain acne lithium toxicity
lithium toxicity
renal impairment diabetes insipidous hypotension arrhythmias irregular pulse
NURSING ACTIONS LITHIUM TOXICITY
get lithium level immediately if signs of ANY toxicity
labs for before lithium tx
kidney/ thyroid function
ecg after 50
wt, bmi
lab tests for maintence
1-2 weeks until stable
monthly first 6 months
check kidney function 1-2 times/ yr
depakote side effects and lab
sedation wt gain hepatoxicity hepatitis prolonged bleeding time
platlet count, liver function, wt every 6 months
lamictil side effects and lab
steven johnson’s syndrome
tegretol side effects and lab
steven johnsons
aplastic anemia
hyponaterima
initiation= cbcb, kidney thyroid function tx= cbc every 2 weeks for 2 months; kidney liver and thyroid function every 6-12 months
teaching for litium
na intake exercise adequate fluid intake wt contreceptative use carry id sx of toxicity
teaching for anitconvolsants
dont stop abruptly
antipsychotic teachin
sunblock
othostatic hypotension
good oral care
no alcohol
